Optimization of Peri-Operative Hdu Care for Elective Colorectal PatientsSiddique K*, Cheema MR, Bapat P andTitu L
Department of Colorectal Surgery, Wirral University Hospitals NHS Foundation Trust, Wirral, United Kingdom
- Corresponding Author:
- Khurram Siddique
Department of Colorectal Surgery
Wirral University Hospitals NHS Foundation Trust
Wirral, H.No: 5, Rockingham Gardens
Rotherham, S60 3BL, United Kingdom
Received Date: April 23, 2014; Accepted Date: August 23, 2014; Published Date: August 29, 2014
Citation: Siddique K, Cheema MR, Bapat P, Titu L (2014) Optimization of Peri- Operative Hdu Care for Elective Colorectal Patients. J Women’s Health Care 3:188. doi:10.4172/2167-0420.1000188
Copyright: © 2014 Siddique K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Despite recent advances,high-risk patients undergoing elective colorectal surgery still have significant morbidity and mortality. For patients electively admitted to level II care, premature discharge can contribute to poor outcomes.
Objectives: The main objectives were to review the level II care provided to high-risk elective colorectal patients with regards to their timing of discharge from the HDU and rate of post-operative complications, re-admissions, total length of stay (LOS) and mortality.
Methods: All elective colorectal patients admitted to HDU during 2010 were included. Patients were divided into two groups with regards to their stay on HDU: Group1 ≤ 48 hrs and Group2 >48 hrs. Data regarding demographics, post-operative complications, LOS, re-admission to HDU and mortality were collected and analysed using SPSS version 14.
Results: Out of the total of 40 patients, 24 (60%) were females; the median age was 74 (IQR 45-92) years. Laparoscopic procedures were performed in 31 (77.5%) patients. There were 26 patients in Group 1 and 14 in Group 2. Post-operative complications were higher (72.2% Vs 27.8%, p-value=0.04), and the LOS was significantly longer amongst Group 1 patients [8 (IQR 4-41) Vs 6.5(IQR4-12) days, p-value 0.03). Four patients in Group 1 were readmitted to HDU compared to none in Group 2. No mortality was observed.
Conclusion: Early discharge from the HDU is associated with significant risk of complications, HDU re-admission (10%) and prolonged LOS. Ensuring a minimum HDU stay of 48 hrs could reduce post-operative morbidity, thus optimizing HDU patient care.